ICL- Implantable Contact Lenses Information Guide

Doctors now have an option for patients not eligible for laser surgery. After years of wearing contact lenses in front of her eyes, Julie Pouncy got hers implanted inside.

Eye surgeon Dr. David Schneider said, “It’s a small lens that is rectangular in shape, similar to a contact lens, it corrects the vision, but it sits inside the eye rather than on the front.”

Pouncy was not a candidate for laser vision correction and this new lens offers her a permanent alternative to glasses.

Schneider said, “It’s made of a material called collimer, which is like collagen found in the body, so the body doesn’t react to it.” Each eye is done separately in different procedures.

In each procedure, the doctor prepares the lens by inserting it into a tiny tube. He then makes a small slit in the surface of the eye which is already numbed with a topical solution and inserts and unrolls the lens.

Each procedure in less than ten minutes. If needed, the lenses can be removed.The implantable contacts cost about a thousand dollars more per eye than laser vision correction. In most cases, they are not covered by medical insurance plans. The risks include infection and about a two percent chance of cataract formation.

The Visian Implantable Collamer Lens (ICL) is a phakic intraocular lens used for the purpose of refractive surgery to correct myopia (nearsightedness). Unlike an intraocular lens that is used during cataract surgery, the Visian ICL does not replace the eye’s natural lens. Instead, the ICL is placed between the iris and the natural lens to allow the ICL lens to work with your natural optical system and allow light to better focus on the retina.

Visian ICL does not permanently alter the structure of the eye, in comparison to corneal refractive surgery. Instead, the phakic intraocular lens is placed in the eye’s posterior chamber, where it works with the natural lens to correct vision.

The phakic intraocular lens does not replace the natural lens, but instead supplements it like a prescription contact lens on the surface of the eye. This lens is sometimes referred to as an implantable contact lens. The Visian ICL offers another option for treating myopia. Now, patients who are seeking the latest approved procedures for vision correction, or who want to avoid the permanence of laser vision correction, have another choice for correcting their nearsightedness.

The Visian ICL features UV eye protection, assisting in the prevention of the development of various eye disorders. UV radiation may contribute to the development of macular degeneration, the leading cause of vision loss among older Americans; and cataracts, a major cause of visual impairment and blindness around the world.

Unlike other phakic IOLs, the Visian ICL is foldable. This feature allows the lens to be implanted using a smaller incision. The small incision procedure is a technique that is familiar to eye surgeons. This smaller incision is less invasive, does not require sutures, and is astigmatically neutral. Although the Visian ICL is meant to stay in the eye indefinitely, it is easily removed by a trained ophthalmic surgeon, leaving the patient’s future options open.

Are you fed up of using high numbered glasses and at the same time, do not enjoy wearing soft contact lenses, then you can be a good candiate for ICL- Implantable Collamer lense.

For cataract patients tired of reading glasses dangling from chains around their necks, there’s a new option in ophthalmology offices: multi-focal, implantable lenses that enable both near and distant vision.

But some Baltimore ophthalmologists caution the lenses, on the market only for a matter of months. Implanted in place of the natural lens to correct cataracts, the multi-focal lenses act as bifocals inside the eye, providing several images - both distant and near - and leaving the brain to choose which one to see, which it often does with little trouble.

Many people in their 40s begin to experience blurred vision when viewing near images because of a loss of flexibility in the lens - a phenomenon called presbyopia, which makes glasses necessary to see clearly up close, said local ophthalmologist Dr. Brett Katzen of Towson’s Katzen Eye Group.

When doctors remove the natural lens to correct the cataract, which is a clouding, darkening and hardening of the lens, they can implant one of the new lenses to correct the patient’s vision altogether, clearing the murky vision and rendering reading glasses unnecessary, Katzen said.

The lenses, sold by several companies in the United States, were approved by the Food and Drug Administration just last spring. Katzen uses one called AcrySof ReSTOR IOL (intraocular lens), made by Alcon Laboratories of Fort Worth, Texas. Another is sold by Advanced Medical Optics Inc., of Santa Ana, Calif. In the dozen or so surgeries in which he’s used the devices since the spring, Dr. Katzen said he’s had excellent results.

People get annoyed [when] every time they want to read they have to go find their glasses, he said. A lot of people get very frustrated with this. For those patients, this gives them the freedom of being able to see near without having to go find their glasses. Katzen said he even is willing to use the lens to correct presbyopia alone, without cataracts. The lenses are not FDA- approved for that purpose, but doctors still can use them for that treatment. But other Baltimore ophthalmologists urge conservative use of the lenses. Dr. Walter Stark of the Wilmer Eye Institute at Johns Hopkins said he won’t touch them just yet.

It’s not that much different from a regular lens, he insisted. The companies that manufacture the devices are trying to get doctors to say that you need this. But the older, mono-focal lens technology is fantastic, for no additional cost, argued Stark, Wilmer’s director of cataract and corneal transplant services. Plus, in the FDA trials, about 25 percent of patients using the new lenses reported nighttime glare, compared to about 9 percent of mono-focal lens patients.

I’m not sure, said Stark of the technology. He hasn’t used it so far in his patients. The current technology is so good, 99.9 percent of my patients are extremely happy. Most, he said, are left only slightly nearsighted - they can see to drive or to read medium-sized print, but to sit down with a novel they have to grab their glasses.

Dr. Don Abrams, chair of Sinai Hospital’s ophthalmology department, said his concern is for the patients who experience trouble discerning which image to see, near or distant. Implanting the new lenses requires doctors to carefully screen patients based on intangibles such as how demanding they are about their vision or what their personality is like. A lot of people love it, he said of the multi-focal lens technology. But I have some questions in my own mind whether or not I would ultimately use it.